Places of care Articles

Spaces that communicate, spaces that treat

Thinking about the public that spaces are intended for

Lucia Fontanella

Linguist, University of Turin

By May 2020July 17th, 2020No Comments
Photo by Lorenzo De Simone

They taught us that the first axiom in the theory of communication – “Everything communicates” – is able to take us very far in the process of comprehending what happens in each day of our daily life.
However, although the axiom seems very transparent and convincing it is actually not that immediate to understand all of its implications.
Let’s focus then, as required, on the spaces of care, viewing them as fundamental instruments of communication.
We could reiterate that they are of great importance, hold a relevant weight and that they should not be neglected, but I believe that’s obvious, so I would propose to mentally visit the healthcare spaces that we are familiar with and that perhaps we did not yet reflect on, to view this issue in a concrete manner.

A visit to the surgery

The space I propose is the surgery of your general practitioner or family doctor. Perhaps you’re wondering how we can reflect together on something that varies case by case. That is actually not a difficult process if we agree on a few simple questions.

1. When we’re waiting to be seen and look around do, we happen to think about the space we’re in?
2. Even though we might have never done that, do we automatically form an opinion?
3. Are the elements that helped us form our opinion clear?
4. If we observe the space in which the physician visits us do, we notice the same characteristics and confirm the same opinion or do we feel something has changed?

Let’s now reflect on the same questions thinking about the spaces of an hospital outpatient clinic, an hospital ward in which we have been admitted or where we’re visiting friends or family, and then, let’s visit carefully hospital administrative places as well.
The point to all this is to get closer to understanding what we do like and what we do not, thus what helps our care and what does not- as that is exactly what we are talking about.
I do not know your answers, but I know mine and given my work I know the results of the studies made in this field. The data shows that aside from the individual differences, evident constants do exist that would allow us to reach sensible guidelines.

After all that’s our home

The most important constant I will focus on is the carefulness/carelessness pair, and I chose these terms given they are composed by the word care.
In order to keep things brief and simple let’s define carefulness as a lack of carelessness and let’s try to better identify the latter (I focus on carefulness because it is what would improve an already acceptable standard situation, while carelessness would not ever reach a level of acceptability – level that must really be reached).
Carelessness can refer to many aspects and it’s often linked to how old spaces are. This is not just an issue in the healthcare world: even in the space of our home we can be careless about some details that surround us and we do this out of habit, laziness and sometime out of personal choice, but after all that’s our home!
This shouldn’t happen in the spaces intended for the public, yet we frequently see on the walls pictures, photographs, posters and informative materials that are not only dated but also in a bad state, and crumpled reading magazines with a disturbing date. It’s the same with the furnishings. Now, interventions on the spaces and often also on the furnishings habitually require investments of a certain weight, but those mentioned above have instead contained costs, and could receive more attention.
It does not need pointing out that, consciously or unconsciously, we tend to associate the carelessness we see with the potential carelessness of our own health care, or if you prefer, the more we’re positively influenced by what we see the more we’re going to feel like we are in good hands.
We then observe that each alive element present in a space that’s intended for the public has the very strong power of making us perceive the space as familiar and welcoming, almost as if it were a gift meant for us. However, if that element is neglected (for example a dying plant or something else), the sense of carelessness increases.

We tend to associate the carelessness we see with the potential carelessness of our own health care.

At a first glance the more recent, modern or super modern facilities almost always evoke a sense of reassurance. That’s due to the same principle cited above, whereby new or unused spaces and furnishings make us think of an efficient facility and therefore also of an efficient care.
As it happens though, we sometime must linger in these spaces and we then happen to discover forms of carelessness that a rational project design should not contemplate. Seat shortages, chairs without armrests, or slippery and very uncomfortable for long waiting times or the long time one spends assisting the sick, the excessive use of metal instead of other more comfortable materials and lack of plugs (nowadays indispensible for everyone and found everywhere). Odd positioning of the beds in relation to screen monitors, and even odder signs such as “Do not go past the yellow line” in the total absence of a yellow line, or “Ring” placed on a button that’s locked in place by tape. I could list several other examples, but I believe these suffice in helping you recall some answers to the questions I asked at the beginning.
They might seem like venial – or rather greatly venial – forms of carelessness but they all originate from the same issue, which is not to think and to continue not to think about the public that the spaces are intended for. Once again this causes us to feel a certain discomfort, with repercussions not only for our opinion of those who treat us but also partly on our opinion of the efficacy of the care itself. In fact, the main care we wish for is genuine attention to be placed on us, not just our sickness.
I should add that project carelessness often turns into routine carelessness whereby facility managers do not take care to report it or apologise for it whenever they cannot provide a solution.
It’s unpleasant to point this out, especially if one has a strong sense of respect for whatever is public, but none of the negative aspects I mentioned above appears in private facilities that do not intend to fail. This would suggest that it is enough to really focus on the needs and preferences of the users to find the appropriate answers and solutions.

The main care we wish for is genuine attention to be placed on us, not just our sickness.

In search of palatability

I asked to also reflect on the possible differences between spaces intended for patients’ waiting and areas meant for patient-doctor meetings and patients’ administration. Very often in fact the latters are perceived as private and receive more care. The doctor’s office or the admin staff’ office often present with plants, flowers, ornaments of a certain value, certainly better furnishings and various embellishments.
The explanation we get is that the longer one spends in a space the more they would tend to embellish it. However, we could argue that the respect for those who require our services, regardless of the length of time they will spend with us, should not lead to a difference in fittings, with the obvious exception of personal items.
I also proposed to reflect on whether we could form an opinion on the palatability of the healthcare spaces that we know personally. I now leave you to compare your answers with the typical and prevalent opinions, which describe a rather lacking general situation that is in need of improvement.
Finally, I would like to remind that the spaces we discussed are populated and this, in the good and in the bad, makes for a greatly significant variable.
Nonetheless, as they say in such cases, that’s another story.

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